| NPI | 1841215530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE WATTLE Office Manager 209-575-4575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA A17110) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2008-08-06 |